By Kit Paternoster
Rosalind was introduced in Part I of this article, “The cost of loneliness,” which was published Sept. 19.
She is a senior citizen in Hancock County. After losing her husband five years ago, she has slowly lost touch with friends and her former social circle. She, like too many local seniors, became reclusive. Her physical health had declined somewhat and her outlook on life became cloudy and grey, with little she looked forward to.
Fortunately, Rosalind has rebounded with the help of some specific assistance that has reconnected her with friends and the community. How this improvement in her life unfolded will be detailed in Part III.
AARP has studied the impact of isolation and loneliness. In a 2015 publication, it points out seniors can better be served by health care and its associated costs by obtaining timely preventive care utilizing improved care coordination.
This also helps reduce the over-utilization of expensive healthcare services and the inappropriate use of police and fire departments.
At a time when healthcare costs continue to spiral ever upward, all healthcare needs to be more proactive instead of reactive. This means targeting intervention before a crisis occurs.
This approach applies not only to physical illness but also to mental health.
When Rosalind was first visited by senior services, permission was obtained to contact her children for their input and perspectives on their mother’s situation. Rosalind also appeared to be depressed, or at least still trying to deal with the loss of her husband.
Barriers in meeting the mental health needs of older adults likely have much to do with the culture of stigmatization and the lack of training and understanding of elders among general practitioners that leads to the lack of referral for optimal care.
The AARP study about isolation and loneliness found hearing loss affected one in three older adults. Limited mobility and lack of access to transportation for those who no longer drive leads seniors to make fewer trips to see a physician when they should, fewer trips to shop or eat out and significantly fewer trips to visit family and friends. Those who experience frequent falls have increasing isolation and loneliness due to fears and realities about recurring falls leading to frailty and a sense of vulnerability. Rosalind had had one fall and had not recently been to her doctor.
As mentioned earlier, loneliness and isolation are public health issues that impact most countries. Studies and surveys conducted in Britain and Canada reveal similar findings to those in the U.S. For example: though the emphasis needs to be on wellness and independence, sometimes the efforts to keep elders in their homes as long as possible may lead to isolation.
Housing insecurity and unsafe neighborhoods foster isolation and loneliness. Adequate transportation is essential, and walkability in one’s environment is crucial. For Rosalind, walking in her neighborhood was not safe.
A Canadian survey revealed that one-half of older women compared to 4 in 10 older men consider themselves to be quite lonely.
A 2015 article in the World Journal of Psychiatry said the subjective feelings of isolation among the elderly can contribute significantly to sleep disturbance, depression and fatigue.
The British Columbia Ministry of Health found that “extreme loneliness seems to be a predictor for rural residents to enter a nursing home … the assumption made by some policy makers that seniors are surrounded by large networks of family, friends and neighbors who provide care if needed is not supported by research.”
This was true for Rosalind.
Rosalind’s children worried she might need assisted living and focused only on that as a solution. There exists a challenge to identify and support vulnerable seniors.
Often, people need help to get help. The objectives in this effort include the ability to remain safely in one’s own home when appropriate, to retain an active social life and to remain integrated into our local communities.
Some of the most effective interventions for loneliness and isolation include: group interventions focused on an educational component that includes participant input; community-developed approaches that target intervention soon after a critical event or life transition; and age-friendly communities.
Fortunately for Rosalind, her situation was made known to those who could provide her with a variety of ways to enhance and enrich her life while still remaining in her home.
Coming up in Part III, we will learn how Rosalind has rebounded and cast a glance toward coming future needs.
Kit Paternoster is the outreach coordinator for Hancock County Senior Services. Questions or comments may be addressed to [email protected].
